Laparoscopic Removal of a Migrated Intrauterine Contraceptive Device With Bladder Penetration

Chuang, Yin-Ting; Yang, Wen-Jui; Lee, Robert Kuo-Kuang; Hwu, Yuh‐Ming

doi:10.1016/s1028-4559(10)60108-8

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…The triad of symptoms most often experienced by women with intestinal injuries includes chronic abdominal pain, fever, and intermittent diarrhea. In the present case, however, the patient complained of feeling strings near her anus (6)(7)(8).…”

contrasting

confidence: 61%

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

Toprak

Gokturk²,

Tolu³

2015

Turk J Gastroenterol

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rectal examination. Colonoscopy revealed that the transverse arms and a part of the horizontal arm of the IUD had penetrated the rectum at 10 cm with protruding strings in the lumen (Figure 2). Retrieval of the IUD by pulling on the threads was attempted but unsuccessful, as the IUD was firmly adherent to the colon wall. Because pulling the strings vigorously to remove the IUD could have resulted in intestinal defects that may have required surgical repair, we decided to remove the IUD by applying traction force. A rubber band was fastened to the strings of the IUD and was stretched by pulling it thorough the anus where the free end of the rubber band was fixed to the buttocks with adhesive tape (Figure 3). The patient was called, and traction applied by the rubber band was checked every other day. On day 4 of the procedure, the IUD was expelled. The area in which the IUD had been embedded was clear.The present case report describes a rectal transmigration of an IUD and its endoscopic removal using a rubber band traction technique without the need for surgery. IUDs are among the most common reversible methods of contraception worldwide. Uterine perforation is the most serious complication associated with IUD insertion, with an estimated incidence of 0 to 10 perforations per 1,000 insertions. Perforations commonly occur at the time of insertion or shortly thereafter, but may also occur many years later. Although the exact mechanism of IUD transmigration accompanied by uterine perforation is not known, the most important risk factors are the skill of the operator; the features of the IUD; the size, shape, and configuration of the uterus; past operations; and timing of insertion after delivery. In the present case, uterine abnormalities were not detected, and there was no previous operation history (3-5).It should be noted that the majority of uterine perforations do not affect other organs; however, 15% of cases lead to complications in adjacent organs, specifically the intestine. Intestinal complications caused by IUD migration include obstruction, infarction, perforation, fistula formation, and mesenteric injury. Penetration of the intestine by an IUD occurs most commonly in the sigmoid colon (40.4%), followed by the small intestine (21.3%) and rectum (21.3%). Patients presenting with uterine perforation may experience pelvic pain, excessive bleeding, and fever; however, migration may be asymptomatic in approximately one-third of patients. The triad of symptoms most often experienced by women with intestinal injuries includes chronic abdominal pain, fever, and intermittent diarrhea. In the present case, however, the patient complained of feeling strings near her anus (6-8).The diagnosis of a transmigrated or dislocated IUD is made by clinical, radiological, and ultrasonographic examination. However, pregnancy should be ruled out before any diagnostic procedure. Other examinations, including hysterography, hysteroscopy, colonoscopy, and laparoscopy, should also be performed as needed. Despite the presence of an I...

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contrasting

confidence: 61%

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

Toprak

Gokturk²,

Tolu³

2015

Turk J Gastroenterol

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“…Misplacement is also a possibility (16). The reported symptoms of intravesical IUD are frequency, hematuria, dysuria, pelvic pain and those related to recurrent urinary tract infections (4)(5).…”

Section: Discussionmentioning

confidence: 99%

“…However, complications such as discomfort (3), lower urinary tract symptoms (4)(5), infertility (6), PID (7), sepsis (3) have been reported in the literature. Also transvesical migration or misplacement of an IUD is a rare complication (2-8-9).…”

Section: Introductionmentioning

confidence: 99%

Bladder Stone and Lower Urinary Tract Symptoms due to Migrated Intrauterine Contraceptive Device: A Case Report and a Brief Review of the Literature

Barlas

Alkibay

Bayram

2017

GMJ

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Transurethral Use of a Nephroscope Significantly Aids in the Surgical Management of an Intrauterine Device Eroding Into the Bladder

Scovell

Chan

Smith³

2014

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Laparoscopic Removal of a Migrated Intrauterine Contraceptive Device With Bladder Penetration

Cited by 4 publications

References 17 publications

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

Bladder Stone and Lower Urinary Tract Symptoms due to Migrated Intrauterine Contraceptive Device: A Case Report and a Brief Review of the Literature

Transurethral Use of a Nephroscope Significantly Aids in the Surgical Management of an Intrauterine Device Eroding Into the Bladder

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